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Shifting gears: Engaging nurse practitioners in prescribing time outdoors


Nurse practitioners can serve as catalysts in promoting healthier lifestyles through Park Prescription initiatives

This essay provides a rationale and description of the Park Prescription (Park Rx) program and offers specific ideas on how nurse practitioners (NPs) can play a role in its implementation. The primary goal of Park Rx is to promote more active lifestyles to reduce chronic diseases, such as coronary artery disease, diabetes, and depression. Park Rx programs can take a variety of forms, but all involve health care providers working with public land agencies and local communities to utilize existing outdoor space (such as trails and parks) as a health-improvement measure. Park Rx’s are written for both children and adults.

Park Rx is based on the understanding that time outdoors offers numerous physical, mental, and social benefits. For children, time in green space has been associated with improved cognition, test scores, and self-discipline. Children also benefit from time in nature by being more physically active and experiencing fewer behavioral issues. In addition to promoting health, Park Rx also exposes children and families to nature and fosters an appreciation of and advocacy for public lands.

Hospitals, schools, urban planners, and other community agencies and service providers are finding innovative approaches to promoting Park Rx programs. Transportation planners are making roadways safer for walking; schools are organizing walk-to-school campaigns; communities are developing field guides to safe and accessible walking environments; and parks are expanding their offerings to include such health-promoting activities as yoga in the park and senior walking programs.

NPs are in a unique position to play key roles in developing and promoting Park Rx initiatives. Health promotion and disease prevention have always been fundamental to their mission. Additionally, recommending time outdoors is consistent with the history of the NP profession and aligns with its focus on holistic health. Recommendations on how NPs can promote more time outdoors include asking their patients about their exercise and stress-reducing habits and about their activity-related interests. They can also work with their patients in setting goals integrating outdoor time into their commute, daily routines, and social life. At the community level, NPs can organize outdoor health-related events in parks and work with community planners in improving and expanding safe outdoor recreation environments for families.

NPs can also be advocates for more equitable access to safe outdoor environments. Low socioeconomic and minority communities tend to have fewer and less well-maintained parks than other communities. Additionally, families living in poorer communities have more limited transportation options to outdoor recreation sites. Thus, at the individual and community levels of intervention, NPs can serve as catalysts in promoting healthier lifestyles.


Wessel, L.A., (2017). Shifting gears: Engaging nurse practitioners in prescribing time outdoors. The Journal for Nurse Practitioners, 13(1), 89-96.


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